title: Digital radiology to improve the quality of care in countries with limited resources: a feasibility study from Angola.
abstract: OBJECTIVE
  Sub-standard quality in X-ray image acquisition and interpretation is common in low-resource countries, and can ultimately result in higher patient morbidity and mortality. This study aimed at evaluating; 1) feasibility of implementing a digital X-ray device in a second level hospital in Angola; 2) quality of digital X-ray images, when digital radiology was in the hands of local technicians; 3) feasibility of digital teleradiology and its potential impact on case management.
  
  
  METHODS
  We developed and tested at the Hospital Divina Providencia (HDP) in Luanda, Angola, a digital X-ray device and a telemedicine network to acquire and print digital X-ray images and send them as DICOM files for remote consultation.
  
  
  RESULTS
  20,564 digital X-ray images were made at HDP from November 2010 to December 2012, with no major technical problems and no need for on-site supervision. Digital radiology largely improved the number of X-ray images of good and very good quality (100% of images with digital radiology, compared to 15% of screen-film images, p<0.0001). Teleradiology using digital images was used in 7.6% of paediatric cases, and provided, in these cases, an important contribution to case management.
  
  
  CONCLUSIONS
  The implementation of a digital X-ray device is feasible in low resource settings with significant improvement in quality of X-ray images compared to standard screen film radiology.
authors.affiliation: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Floriana
authors.initials: F
authors.lastname: Zennaro
authors.forename: Joaquim António
authors.initials: JA
authors.lastname: Oliveira Gomes
authors.forename: Armando
authors.initials: A
authors.lastname: Casalino
authors.forename: Magda
authors.initials: M
authors.lastname: Lonardi
authors.forename: Meta
authors.initials: M
authors.lastname: Starc
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Paoletti
authors.forename: Daniele
authors.initials: D
authors.lastname: Gobbo
authors.forename: Chiara
authors.initials: C
authors.lastname: Giusto
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Not
authors.forename: Marzia
authors.initials: M
authors.lastname: Lazzerini
mesh_terms: D000810:Angola; D003906:Developing Countries; D005240:Feasibility Studies; D006801:Humans; D011787:Quality of Health Care; D011856:Radiographic Image Enhancement; D019112:Teleradiology